Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014.
Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014.
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DOI：
10.1001/jama.2016.20324
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发表时间：
2017-01-24
期刊：
影响因子：
--
通讯作者：
Murray CJ
中科院分区：
文献类型：
--
作者：
Mokdad AH;Dwyer-Lindgren L;Fitzmaurice C;Stubbs RW;Bertozzi-Villa A;Morozoff C;Charara R;Allen C;Naghavi M;Murray CJ
癌症是美国发病率和死亡率的主要原因，并造成沉重的经济负担。估计美国各县 29 种癌症的年龄标准化死亡率。使用了 1980 年至 2014 年国家卫生统计中心 (NCHS) 的未识别死亡记录以及人口普查局、NCHS 和人类死亡率数据库的人口计数。使用经过验证的小区域估计模型来估计 29 种癌症的县级死亡率：唇癌和口腔癌；鼻咽；其他咽部；食管；胃;结肠和直肠；肝;胆囊和胆管；胰;喉;气管、支气管和肺；恶性皮肤黑色素瘤；非黑色素瘤皮肤癌；胸部;颈椎;子宫；卵巢；前列腺;睾丸;肾;膀胱;大脑和神经系统；甲状腺;间皮瘤；霍奇金淋巴瘤；非霍奇金淋巴瘤；多发性骨髓瘤;白血病;和所有其他癌症的总和。居住县。按县、年份、性别和癌症类型划分的年龄标准化癌症死亡率。 1980年至2014年间，美国共有19 511 910人因癌症死亡，其中5 656 423人死于气管癌、支气管癌和肺癌； 2 484 476 因结肠癌和直肠癌； 1 573 593 因乳腺癌； 1 077 030 因前列腺癌； 1 157 878 因胰腺癌； 209 314 因子宫癌； 421 628 因肾癌； 487 518 因肝癌； 13 927 因睾丸癌； 829 396 因非霍奇金淋巴瘤。 1980 年至 2014 年间，癌症死亡率下降了 20.1%（95% 不确定区间 [UI]，18.2%–21.4%），从每 10 万人死亡 240.2 人（95% UI，235.8–244.1）下降到 192.0 人（95% UI，188.6–197.7）。在此期间，各县之间的死亡率存在很大差异：1980 年，科罗拉多州萨米特县的癌症死亡率为每 10 万人 130.6 人（95% UI，114.7–146.0），阿拉斯加北坡自治市的癌症死亡率为 386.9（95% UI，330.5–450.7），而 2014 年，科罗拉多州萨米特县为 70.7（95% UI，63.2–79.0），佛罗里达州联合县为 503.1（95% UI，464.9–545.4）。对于许多癌症来说，存在死亡率特别高的不同县群。这些簇的位置因癌症类型而异，并且分布在美国的不同地区。乳腺癌集群出现在南部地带和密西西比河沿岸，而肝癌在得克萨斯州和墨西哥边境沿线高发，肾癌集群出现在北达科他州和南达科他州以及西弗吉尼亚州、俄亥俄州、印第安纳州、路易斯安那州、俄克拉荷马州、德克萨斯州、阿拉斯加州和伊利诺伊州的县。 1980 年至 2014 年间，美国癌症死亡率总体下降。同一时期，美国各县癌症死亡率的趋势、模式和差异发生了重要变化。这些模式可能为改善预防和治疗的进一步研究提供信息。
Cancer is a leading cause of morbidity and mortality in the United States and results in a high economic burden. To estimate age-standardized mortality rates by US county from 29 cancers. Deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the Census Bureau, the NCHS, and the Human Mortality Database from 1980 to 2014 were used. Validated small area estimation models were used to estimate county-level mortality rates from 29 cancers: lip and oral cavity; nasopharynx; other pharynx; esophageal; stomach; colon and rectum; liver; gallbladder and biliary; pancreatic; larynx; tracheal, bronchus, and lung; malignant skin melanoma; nonmelanoma skin cancer; breast; cervical; uterine; ovarian; prostate; testicular; kidney; bladder; brain and nervous system; thyroid; mesothelioma; Hodgkin lymphoma; non-Hodgkin lymphoma; multiple myeloma; leukemia; and all other cancers combined. County of residence. Age-standardized cancer mortality rates by county, year, sex, and cancer type. A total of 19 511 910 cancer deaths were recorded in the United States between 1980 and 2014, including 5 656 423 due to tracheal, bronchus, and lung cancer; 2 484 476 due to colon and rectum cancer; 1 573 593 due to breast cancer; 1 077 030 due to prostate cancer; 1 157 878 due to pancreatic cancer; 209 314 due to uterine cancer; 421 628 due to kidney cancer; 487 518 due to liver cancer; 13 927 due to testicular cancer; and 829 396 due to non-Hodgkin lymphoma. Cancer mortality decreased by 20.1%(95% uncertainty interval [UI], 18.2%–21.4%) between 1980 and 2014, from 240.2 (95% UI, 235.8–244.1) to 192.0 (95% UI, 188.6–197.7) deaths per 100 000 population. There were large differences in the mortality rate among counties throughout the period: in 1980, cancer mortality ranged from 130.6 (95% UI, 114.7–146.0) per 100 000 population in Summit County, Colorado, to 386.9 (95% UI, 330.5–450.7) in North Slope Borough, Alaska, and in 2014 from 70.7 (95% UI, 63.2–79.0) in Summit County, Colorado, to 503.1 (95% UI, 464.9–545.4) in Union County, Florida. For many cancers, there were distinct clusters of counties with especially high mortality. The location of these clusters varied by type of cancer and were spread in different regions of the United States. Clusters of breast cancer were present in the southern belt and along the Mississippi River, while liver cancer was high along the Texas-Mexico border, and clusters of kidney cancer were observed in North and South Dakota and counties in West Virginia, Ohio, Indiana, Louisiana, Oklahoma, Texas, Alaska, and Illinois. Cancer mortality declined overall in the United States between 1980 and 2014. Over this same period, there were important changes in trends, patterns, and differences in cancer mortality among US counties. These patterns may inform further research into improving prevention and treatment.
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1975年至2012年，向国家报告癌症状况的年度报告，其发病率不断增加。
影响因子：
6.2
作者：
Ryerson AB;Eheman CR;Altekruse SF;Ward JW;Jemal A;Sherman RL;Henley SJ;Holtzman D;Lake A;Noone AM;Anderson RN;Ma J;Ly KN;Cronin KA;Penberthy L;Kohler BA
通讯作者：
Kohler BA
影响因子：
10.3
作者：
Albano, Jessica D.;Ward, Elizabeth;Thun, Michael J.
通讯作者：
Thun, Michael J.
DOI：
10.1001/jama.2016.6361
发表时间：
2016-06-07
期刊：
JAMA
影响因子：
--
作者：
Ogden CL;Carroll MD;Lawman HG;Fryar CD;Kruszon-Moran D;Kit BK;Flegal KM
通讯作者：
Flegal KM
影响因子：
3.3
作者：
Dwyer-Lindgren, Laura;Freedman, Greg;Mokdad, Ali H.
通讯作者：
Mokdad, Ali H.
影响因子：
5.4
作者：
Murray, CJL;Lopez, AD
通讯作者：
Lopez, AD